3种常用材质营养袋对肠外营养液中胰岛素的吸附作用考察

Adsorption Compare of Insulin in Total Nutrient Admixture Solutions Indifferent Material Disposable Parenteral Nutrition Infusion Bags

目的考察滴注过程中3种不同材质的一次性静脉营养输液袋对全合一肠外营养液中胰岛素的吸附作用,为肠外营养集中配制与临床用药提供参考。方法选取聚氯乙烯、乙烯-乙酸乙烯共聚物材质营养袋以及工业化三腔袋,参照《肠外营养配制规范》配制相同处方全合一肠外营养液添加相同剂量胰岛素,持续重力滴注40滴·min^-1(约2 m L·min^-1)高效液相色谱法测定0、2、4、6、8、10、12、14、15 h输液器末端胰岛素浓度。结果 7组全合一肠外营养液在不同时间点的样本测定结果介于理论值的69. 5%~102. 8%之间,最初阶段(0 h、2 h)胰岛素浓度偏低(均值差:2. 4~8. 0 IU·L^-1),4~15 h胰岛素浓度变化不显著,不同材质营养袋对全合一肠外营养液中胰岛素的吸附作用有显著差异:工业化三腔袋与乙烯-乙酸乙烯共聚物(均值差:2. 4 IU·L^-1,P=0. 012)、聚氯乙烯与乙烯-乙酸乙烯共聚物(均值差:1. 6 IU·L^-1,P=0. 020)。结论乙烯-乙酸乙烯共聚物材质营养袋对胰岛素的吸附作用较工业化三腔袋与聚氯乙烯有显著差别,3种材质营养袋中胰岛素浓度在初始阶段(2 h内)偏低,4~15 h浓度没有显著变化,用3种材质营养袋配制全合一肠外营养液时添加胰岛素可作为补充基础胰岛素的方式。

OBJECTIVE To investigate the adsorption of insulin in total nutrient admixture solutions( TNA) in three different material disposable parenteral nutrition infusion bags and provide the reference for compounding of parenteral nutrition and clinical nutrition support. METHODS TNA were compounded according to consensus for parenteral nutrition solutions compounding containing same prescriptions and same dose of insulin in different materialsinfusion bags including polyvinyl chloride( PVC) and ethylene-vinyl acetate copolymer( EVA) and triple chambered bag( TCB). Determination of concentrations of insulin by HPLC for 0,2,4,6,8,10,12,14,15 h with infusion speed 40 drops·min-1( 2 mL·min^-1). RESULTS The results of determination in 7 groups of TNA samples at different time points were between 69. 5% to 102. 8% of the oretical value. The insulin concentrations was low at the initial stage( 0 and 2 h,mean difference: 2. 4-8. 0 IU·L^-1). The concentrations of insulin in 4-15 h was no significant difference.There was a significant difference in different material bags: TCBvs EVA( mean difference: 2. 4 IU·L^-1,P = 0. 012). PVC vs EVA( mean difference: 1. 6 IU·L^-1,P =0. 020). CONCLUSION The adsorption of insulin in EVA material bags is significantly different from that in TCB and PVC,the concentrations of insulin in TNA of different material bags was low in the initial stage( 0 and 2 h).There is no significant difference in the concentrations of insulin at 4-15 h. When TNA is compounding in EVA,PVC and KABI nutritional bags,insulin can be used as a way to supplement for patients daily needs.